Anxiety
Disorders
Definition of Anxiety

Anxiety is a feeling of apprehension or fear.
The source of this uneasiness is not always
known or recognized, which can add to the
distress you feel.
 Anxiety disorders are a group of psychiatric
conditions that involve excessive anxiety.
Anxiety disorders…
Highly treatable yet also resistant to
extinction
 Often begins early in life
 Reported more by women than men
 Reported more in Western countries
 Often comorbid both with other anxiety
diagnoses and with other disorder
groups (e.g. Mood disorders,
psychoses)

Anxiety Disorders
Phobias
Panic disorder
GAD: Generalized Anxiety
Disorder
PTSD: Post-traumatic stress
disorder
OCD: Obsessive Compulsive
Disorder
Anxiety Facts
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Anxiety disorders affect 12% of the population, causing mild to severe impairment.
Measured for the first time in 2013, 2.6% of Canadians had generalized anxiety disorder
One in four Canadians (25%) will have at least one anxiety disorder in their lifetime
Anxiety is the most common mental illness in Canada.
Hospitalization rates for anxiety disorders in general hospitals are twice as high among women
as men.
Anxiety disorders can be effectively treated in the community setting.
Most common mental illness in the U.S. with 19 million of the adult (ages 18-54) U.S.
population affected.
Anxiety disorders cost more than $42 billion a year.
More than $22 billion are associated with the repeated use of healthcare services, as
those with anxiety disorders seek relief for symptoms that mimic physical illnesses.
Anxiety is highly treatable (up to 90% of cases), but only one-third of those who suffer
from it receive treatment
Depression often accompanies anxiety disorders
2003 Anxiety Disorders Association of America
Anxiety Statistics
Anxiety Disorders
One-Year Prevalence (Adults)
Percent
Population Estimate*
(Millions)
Any Anxiety Disorder
13.3
19.1
Panic Disorder
1.7
2.4
Obsessive-Compulsive
Disorder
2.3
3.3
Post-Traumatic Stress
Disorder
3.6
5.2
Any Phobia
8.0
11.5
Generalized Anxiety
Disorder
2.8
4.0
* Based on 7/1/98 U.S. Census resident population estimate of 143.3 million, age 18-54
How common are psychological
disorders?
Countries vary greatly in the percentage of people reporting
mental health issues in the past year.
4. More considered
response based on
cortical processing
1. Thalamus receives
stimulus and sends to
both amygdala and
cortex
Sensory Input
2. Amygdala
registers
danger
3. Amygdala
triggers fast
response
• Parts of the brain involved in fear response = thalamus, amygdala, hypothalamus,
which then instruct the endocrine glands and autonomic nerv.sys.
• Evolved fear module (pink) versus considered response (red) = “fight or flight”
versus “feel the fear and do it anyway (or do it differently)”!
Panic Disorder: “I’m
Dying”
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The abrupt onset of an episode of
intense fear or discomfort, which
peaks in approximately 10 minutes
Anyone can experience a panic
attack, but some people have panic
attacks repeatedly, unexpectedly, and
without apparent reason
The fear of having a panic attack
becomes a problem of itself,
possibly leading to agoraphobia
Comer, Fundamentals of
Abnormal Psychology, 3e
10
Comer, Fundamentals of
Abnormal Psychology, 3e
11
Generalized
Anxiety
Disorder
Similar to
Panic disorder
however,
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Symptoms must occur
for at least 6 months
and include chronic
anxiety not associated
with any specific
situation or object
The individual
frequently
experiences:
 Sleep problems
 Difficulty
concentrating
 Irritability
 Tenseness
 Being hypervigilant

https://www.youtube.c
om/watch?v=KbY4HG
4Uod4
Comer, Fundamentals of
Abnormal Psychology, 3e
13
Post-Traumatic
Stress Disorder
[PTSD]
About 10 to 35 percent of people
who experience trauma not only
have burned-in memories, but
also four weeks to a lifetime of:
 repeated intrusive recall of
those memories.
 nightmares and other reexperiencing.
 social withdrawal or phobic
avoidance.
 jumpy anxiety or
hypervigilance.
 insomnia or sleep problems.
Prevalence of PTSD
prevalence among general population is
7.8%
 prevalence among survivors of trauma
is 17.9%

– victims of rape = 33%
– male Vietnam combat veterans = 31%
– victims of serious car accidents = 25%
PTSD
– Dr. Amen
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https://www.youtu
be.com/watch?v=
LM_nw5N3n-I
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6 minutes
Common Causes
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There is no one cause for anxiety disorders.
Several factors can play a role
– Genetics
– Brain biochemistry
– Overactive "fight or flight" response
• Can be caused by too much stress
– Life circumstances
– Personality
• People who have low self-esteem and poor coping skills may be
more prone
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Certain drugs, both recreational and medicinal,
can lead to symptoms of anxiety due to either side
effects or withdrawal from the drug.
In very rare cases, a tumor of the adrenal gland
(pheochromocytoma) may be the cause of anxiety.
Behavioral and Cognitive Therapy
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Teaches patient to react differently to situations and
bodily sensations that trigger anxiety
 Teaches patient to understand how thinking patterns
that contribute to symptoms
 Patients learn that by changing how they perceive
feelings of anxiety, the less likely they are to have
them
 Examples: Hyperventilating, writing down list of top
fears and doing one of them once a week, spinning in
a chair until dizzy; after awhile patients learned to
cope with the negative feelings associated with them
and replace them with positive ones
Medical Treatment
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antidepressants are first drug choice
 SSRIs: increase levels of serotonin
 Tricyclics: increase levels of serotonin and
norepinephrine
– imipramine (Tofranil)
– clomipramine (Anafranil)
 take about 4 weeks to work, but are generally safe
and not addicting
 SSRIs are currently drug of choice